What Is Cyclothymia?

Cyclothymia, also called cyclothymic disorder, can be clinically defined as "a mood disorder that causes emotional highs and lows." According to the American Psychiatric Association, cyclothymic disorder can be considered a milder form of bipolar disorder. Individuals with cyclothymia may experience mood swings that include periods of hypomanic symptoms (“highs”) as well as periods of depressive symptoms (“lows”). Approximately .4-1% of people in the United States are thought to live with cyclothymic disorder; but, according to some experts in epidemiology, cyclothymia is more common than the numbers suggest. In a study published in the Clinical Psychology Review, researchers stated that cyclothymic disorder “may be the most prevalent form of bipolar disorder”. 

Despite being a less severe form of bipolar disorder, cyclothymia and its resultant mood changes and emotional instability can significantly impact an individual’s life. Those who are diagnosed with cyclothymia may have a higher likelihood of being diagnosed with bipolar disorder later in life. Therapy, whether in person or online, may be one way to address symptoms of cyclothymia and improve quality of life. 

Hypomanic and depressive symptoms of cyclothymia

Cyclothymia is a less severe form of bipolar disorder characterized by symptoms of mild depression and hypomania. For an individual to receive a diagnosis of cyclothymia, they generally must meet certain benchmarks established by the American Psychiatric Association, including extended periods of hypomanic symptoms and depressive symptoms that are not caused by substance use, medication intake, or other medical concerns, over a duration of at least two years. To meet the diagnostic criteria, symptoms must have been present for at least one of those two years, and any periods of normal mood must not have lasted more than two months. Furthermore, the symptoms must usually be severe enough to have adverse effects on everyday life scenarios, such as work, school, or other social settings.

Though the hypomanic and depressive symptoms of cyclothymic disorder do not rise to the level of diagnosable hypomania or major depression, they can lead to significant complications. A person with cyclothymia who is experiencing a hypomanic high may experience an inflated sense of self-esteem or self-confidence. They might feel euphoric, invincible, and hyperactive. They may also experience insomnia and have trouble thinking before acting. Cyclothymic highs can also include excessive talking, difficulty concentrating, impulse control challenges, and reckless or irresponsible behavior.

Depressive lows often follow hypomanic highs. A person with cyclothymia who is experiencing a depressive period may feel lonely, restless, or unmotivated. They may struggle to solve problems, make plans, and weigh decisions, and they could experience low self-confidence, drastic weight changes, feelings of guilt or worthlessness, or thoughts of self-harm or suicide. 

If you or a loved one is experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide and Crisis Lifeline can be reached 24 hours a day by dialing 988.

Not everyone who experiences symptoms of cyclothymia may seek treatment. Some individuals may find that they are more energetic or productive during hypomanic periods. However, these temporary highs can be destabilizing if left unchecked, especially because they may be followed by depressive periods. If you are experiencing symptoms of cyclothymia, you might consider contacting a mental health professional who may be able to support you with resources and strategies to manage your symptoms in the long run.

What causes cyclothymia?

The cause of cyclothymic disorder, like bipolar disorder, generally remains unknown. However, research indicates that several possible factors may contribute to a diagnosis of cyclothymia, including genetics, differences or changes in brain function, and stressful or traumatic events (e.g., severe illness). Research shows that a family history of bipolar disorder and other mood disorders is associated with an increased risk of developing cyclothymia. Regardless of the cause of cyclothymia, it can be important to remember that no one may be at fault when receiving a diagnosis of this condition, and emotional support and professional treatment may manage symptoms over the long term.

Treatment options for bipolar mood disorders

Identifying and addressing the symptoms of cyclothymic disorder in a timely manner can be crucial to effective care. In a review titled “Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder”, researchers stated, “The early detection and treatment of cyclothymia can guarantee a significant change in the long-term prognosis”. Usually, before a professional can diagnose cyclothymia, they must rule out other mental health conditions with similar symptoms. Cyclothymia’s symptoms overlap with those of several separate disorders, including certain personality disorders (e.g., borderline personality disorder), neurodevelopmental disorders (e.g., ADHD), and affective disorders (e.g., major depressive disorder).  

Many treatment options may be available for cyclothymic disorder. A mood stabilizer—a type of medication often used to treat other bipolar spectrum disorders—will typically be a primary component of an individual’s treatment plan. As discussed in the above-mentioned review, cyclothymia can be a “misconceived affective disorder”, leading some to treat it with medications that exacerbate symptoms, such as SSRIs. For this reason, if you’ve decided to seek medical care for cyclothymia, understanding the potential effects of medications can be crucial. Always consult with a healthcare professional prior to starting or stopping any medication. 

There are several types of therapy used to treat bipolar and related disorders, such as cognitive behavioral therapy, dialectical behavioral therapy, and interpersonal/social rhythm therapy. Each of these therapy types is discussed in greater detail below.

Cognitive behavioral therapy

Levels of trust, openness, and communication can play critical roles in this form of therapy so that the therapist can lead an open dialogue and effectively treat cyclothymia. Research suggests that CBT that focuses on cognitive control and mindfulness skills may be useful for the treatment of cyclothymia.

Dialectical behavior therapy

Another treatment option for cyclothymia may be dialectical behavior therapy (DBT). This type of treatment often centers on addressing distress, managing one's emotions, and gaining self-awareness with the guidance of a mental healthcare professional. 

Although there is currently no cure for cyclothymia, DBT may empower you to manage the disorder over time, and many individuals may find that the skills learned through DBT can be useful during hypomanic or depressive episodes. Similar to CBT, DBT can be an individualized, collaborative, step-by-step process.

Interpersonal and social rhythm therapy

An additional treatment option for cyclothymia may be interpersonal and social rhythm therapy (IPSRT), which is generally rooted in establishing daily routines and circadian rhythms to provide an individual with patterns and schedules. IPSRT normally aims to help individuals with cyclothymia gain control over hypomanic and depressive episodes by structuring their lives more intentionally, including sleep schedules, mealtimes, and other daily activities. Mood disorders like cyclothymia can be made more severe by instability, so in some cases, establishing more structure with the guidance of a therapist may help.

In addition to the treatments listed above, some individuals living with cyclothymia may find prescribed medications to be helpful. Your primary care provider may recommend a treatment plan that includes medication and talk therapy. Talk therapy can be a viable long-term treatment for many mental health disorders, and if you think you might have cyclothymic disorder, you might consider reaching out to a mental health professional for help managing your symptoms. Always speak to a doctor or psychiatrist regarding medication options.

Effectiveness of therapy for cyclothymia

If you or a loved one is experiencing symptoms of cyclothymia, you are not alone, and help is available. A licensed mental health professional may be able to provide a diagnosis of cyclothymia and recommend a course of treatment to manage symptoms. With adequate treatment and support, a person with cyclothymia can lead a productive, fulfilling life. 

Benefits of online therapy

If you’re not comfortable seeing a therapist in person, you might opt for online therapy. Online therapy services like BetterHelp have generally made it possible to receive treatment from the comfort of your home, which may be helpful if you’re experiencing symptoms of cyclothymia, like a significant loss of energy or decreased ability to concentrate. 

Effectiveness of online therapy

According to a 2021 study, online therapy may be helpful in improving both manic and depressive symptoms. Those interested in seeking professional help for cyclothymia may find that both online and in-person options can be valid choices for treatment.